The Health Impact of Supportive Housing for HIV-Positive Homeless Patients: A Randomized Controlled Trial
- 1 November 2009
- journal article
- research article
- Published by American Public Health Association in American Journal of Public Health
- Vol. 99 (S3), S675-S680
- https://doi.org/10.2105/ajph.2008.137810
Abstract
Objectives. We assessed the health impact of a housing and case management program, the Chicago Housing for Health Partnership, for homeless people with HIV. Methods. HIV-positive homeless inpatients at a public hospital (n = 105) were randomized to usual care or permanent housing with intensive case management. The primary outcome was survival with intact immunity, defined as CD4 count ≥ 200 and viral load < 100 000. Secondary outcomes were viral loads, undetectable viral loads, and CD4 counts. Results. Outcomes were available for 94 of 105 enrollees (90%). Of 54 intervention participants, 35 (65%) reached permanent housing in program housing agencies. After 1 year, 55% of the intervention and 34% of the usual care groups were alive and had intact immunity (P = .04). Seventeen intervention (36%) and 9 usual care (19%) participants had undetectable viral loads (P = .051). Median viral loads were 0.89 log lower in the intervention group (P = .03). There were no statistical differences in CD4 counts. Conclusions. Homelessness is a strong predictor of poor health outcomes and complicates the medical management of HIV. This housing intervention improved the health of HIV-positive homeless people.Keywords
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